Sleep Apnea

If you wake up as tired as when you went to bed, you may suffer
from sleep apnea. Characterized by short lapses in breathing, sleep
apnea affects an estimated 12 million Americans. Although sleep
apnea can seem like just a mild annoyance, this condition has been
linked with other health concerns high blood pressure, heart
disease, memory problems, and daytime drowsiness.

Defining Sleep ApneaSleep apnea is a sleep
disorder in which the patient experiences shallow breathing or
pauses in breathing during sleep. These pauses can occur several
times during sleep, leading to health complications and lifestyle
hindrances.

Because sleep apnea can impact other areas of your life, it's
important to take any symptoms seriously. If you suspect sleep
apnea, talk to your dentist or physician about having a complete
exam. Often, your doctor will recommend a sleep study to help
confirm sleep apnea. Common symptoms of sleep apnea can
include:

Abnormal sleep patterns

Choking during sleep

Daytime sleepiness

Difficulty with concentration

Dry mouth or sore throat in the morning

Erectile dysfunction

Falling asleep at inappropriate times

Frequent pauses during sleep due to breaks in breathing

High blood pressure

Irritability

Loud snoring

Sudden awakenings to restart breathing

Waking up in a sweat

The four types of sleep apnea are:

Obstructive sleep apnea - The most common form of this
disorder, obstructive sleep apnea (OSA) occurs when a patient's
throat closes as the individual inhales during sleep and the patient
can not suck air into their lungs. Since muscles relax during sleep,
the soft tissue of the pharynx relaxes and expands, obstructing air
flow in the upper respiratory tract. This obstruction reduces the
amount of oxygen in the blood and forces the patient to wake up and
take a deep breath. Men from age 30 to 50 are the main group
affected by OSA. Often, people will experience mild OSA at some
point in time in their lives; however, chronic or severe OSA
requires medical attention.

Central sleep apnea - Central sleep apnea, or Cheyne-Stokes
respiration, is a relatively rare form of sleep apnea that occurs
when the region of the brain responsible for controlling the
breathing muscles temporarily fails. Central sleep apnea differs
from OSA in that the patient's pauses in breathing are due to a lack
of effort to breathe.

Mixed apnea - Mixed apnea is a combination of OSA and central
sleep apnea. Chronic OSA can sometimes cause central sleep apnea.
Although the exact cause is still unknown, weight-related,
cardiovascular, and respiratory conditions can contribute to mixed
sleep apnea.

Complex sleep apnea - Complex sleep apnea is a form of mixed
sleep apnea. With this unusual condition, a patient still
experiences sleep apnea even when the physical obstruction to
breathing is removed.

Factors that Influence Sleep ApneaObstructive sleep apnea is caused when soft tissue in the
airway relaxes. Usually, OSA occurs because of changes in muscle
tone, increase in the soft tissue due to obesity, and structure
issues with the skull and face. Obese people are at a great risk for
OSA because they carry more muscle and tissue mass. Over 50 percent
of those who have Down's syndrome suffer from OSA, brought on by
poor muscle tone, narrow nasopharynx, and a large tongue. Nasal
congestion and alcohol consumption can also contribute to OSA.
Enlarged tonsils and adenoids are the most common causes of
obstructive sleep apnea in children. Obstructive sleep apnea can
also occur as a part of the natural ageing process when the brain's
capacity to transmit instructions telling the throat muscles to
maintain rigidity decreases.

Central sleep apnea often accompanies a medical condition and is
rarely found in healthy individuals. Since the brainstem controls
breathing, any medical condition involving that part of the brain
can cause central sleep apnea. Cardiovascular conditions,
neurodegenerative conditions such as Parkinson's disease, advanced
arthritis, and encephalitis are some medical conditions that can
trigger central sleep apnea.

The Importance of TreatmentComplications
from sleep apnea can include inattentiveness at work, tiredness,
risk of accidents, mood swings, high blood pressure and erectile
dysfunction. Sleep apnea can also increase the risk of congestive
heart failure and stroke. It can lead to difficulty in the treatment
processes for conditions such as arterial fibrillation. Children
affected by sleep apnea can be hyperactive, high strung, aggressive,
and prone to bed wetting. They may have also unusual sleeping
positions. Overall, a person suffering from sleep apnea experiences
deterioration in the quality of life.

Diagnosing Sleep ApneaTo look for
sleep apnea, a dentist or physician can recommend diagnostic
testing, particularly if the patient is suffering from conditions
such as high blood pressure, heart failure, and epilepsy. Physical
examination for adults includes measuring for a wide neck, looking
for enlarged tonsils, and assessing upper body obesity. In
evaluating children, doctors check for enlarged adenoids and
determine if the child has attention deficit issues.

Doctors use the patient's medical and sleep history in diagnosing
sleep apnea. Symptoms such as drowsiness, headaches, heartburn, and
patient medications can influence the diagnosis. A sleep study,
where the patient is monitored in a sleep lab, can also help
determine an individual has sleep apnea. When testing rules out
sleep apnea, then the patient must be evaluated for other potential
sleep disorders.

Behavioral changes - In many cases, lifestyle and behavior
changes are often the only treatment required to treat sleep apnea,
particularly the milder cases. Exercising to reduce weight and
avoiding sleep positions that lead to increased snoring have been
shown as effective treatments.

Dental appliances - Mild to moderate sleep apnea can be
controlled by using dental appliances that hold the palate up and
keep the airway free. Any dental appliance should be custom fit by a
dentist so that it works properly. Continuous positive airway
pressure (CPAP) machines use air pressure to ensure that the soft
palate does not sag during sleep. The pressurized air is delivered
to the patient through a face mask. As the person breathes, gentle
air pressure keeps the air passage open and prevents sleep
apnea.